The New York Times has a moving and personal essay (In Breast Cancer, There Is a Single Agenda: Stay Alive, New York Times, October 31, 2006) by Aliyah Barukin today where she reflects on her journey through cancer diagnosis, treatment and survivorship. Last but not least, because of being half Ashkenazi Jewish, she describes the experience having and receiving genetic testing results for BRCA1 and BRCA2 mutations.
I will not be a spoiler and reveal how the story ends, but Ms. Barukin's reflections made me think of a conversation I had with a colleague who worked in the Cancer Control Division at CDC who made the connection between inherited susceptibility for cancer and survivorship. In all cases, the story starts with the person with cancer, but quickly radiates to other family members. In both cases, the threat of an untimely end of life heightens sensations, fears, and feelings of vulnerability in both the person with cancer and those closest to her. In both cases, the consequences of the disease cross generations, both in terms of guilt of passing on the increased risk for cancer and the guilt of leaving children behind without a parent. In both cases, there is the need to learn to live with the very real specter of cancer recurring (or occurring) and the real threat of untimely illness and death that family members share.
When it comes to our health and wellbeing, we all are only one step away from disaster at any time. One false step, one moment of inattention behind the wheel, one wrong move that results in serious injury can bring lifechanging circumstances for us and our families. However, for most of us, we learn to delude ourselves that the abyss is not really there, that these horrific events will only happen to someone else. For those who have had cancer or have an inherited predisposition to cancer, that comforting delusion is shattered and cannot be easily recovered and they must learn to live with the knowledge of the tenuous nature of good health. In these ways--and probably others--the knowledge of an inherited susceptiblity for cancer and surviving a cancer diagnosis are similar.